A reference equation for maximal aerobic power for treadmill and cycle ergometer exercise testing: Analysis from the FRIEND registry

Silva, Christina Grüne de Souza e; Kaminsky, Leonard A.; Arena, Ross; Christle, Jeffrey W.; Araújo, Cláudio Gil Soares de; Lima, Ricardo Moreno; Ashley, Euan A.; Myers, Jonathan

doi:10.1177/2047487318763958

Cited by 77 publications

(73 citation statements)

References 32 publications

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“…With the publication of several databases with a large population with the direct measurement of VO 2 max, a great interest was developed in the development of equations to estimate VO 2 max. Recently, the FRIEND equation predicted the VO 2 max with an overall error >4 times lower than the error associated with the traditional American College of Sports Medicine equations (5.1±18.3% vs. 21.4±24.9%, respectively) [18,19]. Souza and Silva developed a bicycle and treadmill equation derived from the FRIEND data and compared this equation with those that previously existed, and they found that the VO 2 max values derived using the former equation were significantly closer to the actual VO 2 max values than that calculated using the older equations.…”

Section: Discussionmentioning

confidence: 99%

Cardiorespiratory fitness data from 18,189 participants who underwent treadmill cardiopulmonary exercise testing in a Brazilian population

et al. 2019

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PurposeCardiorespiratory fitness is inversely associated with a high risk of cardiovascular disease, all-cause mortality, and mortality attributable to various cancers. It is often estimated indirectly using mathematical formulas for estimating oxygen uptake. Cardiopulmonary exercise testing, especially oxygen uptake, represents the “gold standard” for assessing exercise capacity. The purpose of this report was to develop reference standards for exercise capacity by establishing cardiorespiratory fitness values derived from cardiopulmonary exercise testing in a Brazilian population. We focused on oxygen uptake standards and compared the maximal oxygen uptake [mLO2·kg-1·min-1] values with those in the existing literature.MethodsA database was constructed using reports from cardiopulmonary exercise testing performed at Fleury laboratory. The final cohort included 18,189 individuals considered to be free of structural heart disease. Percentiles of maximal oxygen uptake for men and women were determined for six age groups between 7 and 84 years. We compared the values with existing reference data from patients from Norway and the United States.ResultsThere were significant differences in maximal oxygen uptake between sexes and across the age groups. In our cohort, the 50th percentile maximal oxygen uptake values for men and women decreased from 44.7 and 36.3 mLO2·kg-1·min-1 to 28.4 and 22.3 mLO2·kg-1·min-1 for patients aged 20–29 years to patients aged 60–69 years, respectively. For each age group, both Norwegian men and women had greater cardiorespiratory fitness than cohorts in the United States and Brazil.ConclusionTo our knowledge, our analysis represents the largest reference data for cardiorespiratory fitness based on treadmill cardiopulmonary exercise testing. Our findings provide reference values of maximal oxygen uptake measurements from treadmill tests in Brazilian populations that are more accurate than previous standard values based on workload-derived estimations. This data may also add information to the global data used for the interpretation of cardiorespiratory fitness.

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Section: Discussionmentioning

confidence: 99%

Cardiorespiratory fitness data from 18,189 participants who underwent treadmill cardiopulmonary exercise testing in a Brazilian population

et al. 2019

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“…Peak V O 2 was defined as a 30-s rolling average of the six highest 5-s oxygen uptake values. Participants were classified as having impaired peak VO 2 if they achieved < 85% of predicted values for children/ adolescents [16] or adults [17] in line with American Thoracic Society guidelines for CPET interpretation [18]. The anaerobic threshold was calculated using the V-slope method [19], with the VO 2 at the anaerobic threshold expressed as an absolute value and as a proportion of each participant's predicted peak VO 2 .…”

Section: Exercise Capacitymentioning

confidence: 99%

Exercise cardiovascular magnetic resonance reveals reduced cardiac reserve in pediatric cancer survivors with impaired cardiopulmonary fitness

Foulkes

Costello

Howden

et al. 2020

Journal of Cardiovascular Magnetic Resonance

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Background: Pediatric cancer survivors are at increased risk of cardiac dysfunction and heart failure. Reduced peak oxygen consumption (peak VO 2) is associated with impaired cardiac reserve (defined as the increase in cardiac function from rest to peak exercise) and heart failure risk, but it is unclear whether this relationship exists in pediatric cancer survivors. This study sought to investigate the presence of reduced peak VO 2 in pediatric cancer survivors with increased risk of heart failure, and to assess its relationship with resting cardiac function and cardiac haemodynamics and systolic function during exercise. Methods: Twenty pediatric cancer survivors (8-24 years; 10 male) treated with anthracycline chemotherapy ± radiation underwent cardiopulmonary exercise testing to quantify peak VO 2 , with a value < 85% of predicted defined as impaired peak VO 2. Resting cardiac function was assessed using 2-and 3-dimensional echocardiography, with cardiac reserve quantified from resting and peak exercise heart rate, stroke volume index (SVI) and cardiac index (CI) using exercise cardiovascular magnetic resonance (CMR). Results: Twelve of 20 survivors (60%) had reduced peak VO 2 (70 ± 16% vs. 97 ± 14% of age and gender predicted). There were no differences in echocardiographic or CMR measurements of resting cardiac function between survivors with normal or impaired peak VO 2. However, those with reduced peak VO 2 had diminished cardiac reserve, with a lesser increase in CI and SVI during exercise (Interaction P < 0.01 for both), whilst the heart rate response was similar (P = 0.71). Conclusions: Whilst exercise intolerance is common among pediatric cancer survivors, it is poorly explained by resting measures of cardiac function. In contrast, impaired exercise capacity is associated with impaired haemodynamics and systolic functional reserve measured during exercise. Consequently, measures of cardiopulmonary fitness and cardiac reserve may aid in early identification of survivors with heightened risk of long-term heart failure.

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“…6 Numerous limitations associated with the W/H equations have been reported, including the fact that they were derived from a relatively small and homogeneous cohort. 7,8…”

Section: How Do We Evaluate Oxygen Uptake and Should It Be Normalized For Age?mentioning

confidence: 99%

Reply to commentary on: Prediction of VO2peak by an endurance test and prognostic value of the FRIEND equation

Grazzi

Myers

Arena

et al. 2020

European Journal of Preventive Cardiology

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A reference equation for maximal aerobic power for treadmill and cycle ergometer exercise testing: Analysis from the FRIEND registry

Cited by 77 publications

References 32 publications

Cardiorespiratory fitness data from 18,189 participants who underwent treadmill cardiopulmonary exercise testing in a Brazilian population

Cardiorespiratory fitness data from 18,189 participants who underwent treadmill cardiopulmonary exercise testing in a Brazilian population

Exercise cardiovascular magnetic resonance reveals reduced cardiac reserve in pediatric cancer survivors with impaired cardiopulmonary fitness

Reply to commentary on: Prediction of VO2peak by an endurance test and prognostic value of the FRIEND equation

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